High dose of buprenorphine in terminally ill patient with liver failure: efficacy and tolerability

J Opioid Manag. 2012 Jul-Aug;8(4):253-9. doi: 10.5055/jom.2012.0123.

Abstract

Pain in terminally ill patients with cancer can be often hard to manage, due to the unpredictable kinetics of drugs caused by progressive kidney and liver dysfunction. Plasma concentrations of active metabolites-also a cause of dangerous side effects--could be difficult to estimate. This case report holds the idea that buprenorphine, a partial agonist of m-receptors, even at high dosage, may be effective and safe to use in terminally ill patients with significant liver and kidney impairment.

Publication types

  • Case Reports

MeSH terms

  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use*
  • Buprenorphine / adverse effects
  • Buprenorphine / therapeutic use*
  • Dose-Response Relationship, Drug
  • Humans
  • Kidney / physiopathology
  • Liver / physiopathology
  • Liver Failure / complications
  • Liver Failure / physiopathology*
  • Male
  • Middle Aged
  • Pain / drug therapy*
  • Pain / etiology
  • Pain / physiopathology
  • Pain Measurement / methods
  • Pancreatic Neoplasms / complications
  • Pancreatic Neoplasms / physiopathology
  • Terminally Ill

Substances

  • Analgesics, Opioid
  • Buprenorphine